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KMID : 0361819880070020181
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Journal of the Korean Society of Medical Ultrasound
1988 Volume.7 No. 2 p.181 ~ p.185
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Duplex Doppler Sonography of Renal Allograft in Acute Rejection
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禹聖龜/Woo, Seong Ku
金玄撤/朴成培/Kim, Hyun Chul/Park, Sung Bae
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Abstract
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Although the clinical diagnosis of acute renal allograft failure is obvious, the specific cause frequently is obscure. Imaging studies have been able to distinguish obstruction and the presence of peritranspiant collection from other causes of renal failure, such as acute rejection, acute tubular necrosis, and cyclosporine toxicity. But differentiation of rejection from other causes of acute renal failure frequently is difficult, and there is lack of specificity. Duplex Doppler sonography has shown promise in its ability to differentiate acute rejection from acute tubular necrosis and cyclosporine toxicity. The authors performed duplex Doppler sonographic examination in 7 cases of clinically proven acute allograft rejection and in 19 cases of normal transplant. Abnormal decreased diastolic waveform are seen at 6 cases of 7 rejecting transplants. Moreover, early rejection was accurately detected in 4 cases several days earlier prior to clinical manifestation of acute rejection. But there are 2 false-positive cases showing transitory abnormal diastolic waveform in 19 cases of normal transplant. Also we measured a resistance index at the interlobar and arcuate artery level. With a RI greater than 91%, acute rejection was highly likely. A value less than 60% was unlikely to be rejection. The authors concluded that duplex Douppler sonography is useful, noninvasive modality in early and accurate detection of acute rejection and the differentiation from other causes of acute failure, and in monitoring of rejecting patients.
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KEYWORD
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